BILL NUMBER: SB 2180	CHAPTERED  09/29/00

	CHAPTER   869
	FILED WITH SECRETARY OF STATE   SEPTEMBER 29, 2000
	APPROVED BY GOVERNOR   SEPTEMBER 28, 2000
	PASSED THE SENATE   AUGUST 31, 2000
	PASSED THE ASSEMBLY   AUGUST 29, 2000
	AMENDED IN ASSEMBLY   AUGUST 28, 2000
	AMENDED IN ASSEMBLY   AUGUST 18, 2000
	AMENDED IN ASSEMBLY   AUGUST 7, 2000
	AMENDED IN SENATE   MAY 30, 2000
	AMENDED IN SENATE   APRIL 24, 2000

INTRODUCED BY   Committee on Health and Human Services (Senators
Escutia (Chair), Figueroa, Hughes, Polanco, Solis, and Vasconcellos)

                        FEBRUARY 29, 2000

   An act to amend Sections 1572, 1575.3, 1575.4, 1576, 1580.5, and
1590.5 of, to add Sections 1575.45 and 1590.3 to, the Health and
Safety Code, to amend Section 14574 of, and to add Section 14574.1
to, the Welfare and Institutions Code, relating to adult day health
care.



	LEGISLATIVE COUNSEL'S DIGEST


   SB 2180, Committee on Health and Human Services.  Adult day health
care:  licensing.
   (1) Existing law establishes the Long-Term Care Committee within
the California Department of Aging.  The duties of the committee are
to act as an advisory body to the department and advise the Director
of the California Department of Aging on development of
community-based long-term care programs.
   Existing law requires the committee to review and make
recommendations on guidelines to evaluate community need to be
adopted by the director.
   This bill, instead, would require the department to prepare
guidelines to evaluate community need to be adopted by the local
planning council.
   (2) Existing law requires the committee to review county adult day
health care plans.
   This bill would require the department, rather than the committee,
to review county adult day health care plans.
   (3) Existing law requires the committee to review and make
recommendations to the director on individual proposals for startup
funds and original licensure of proposed adult day health care
centers.  Existing law authorizes the committee to conduct onsite
inspections to evaluate a proposed provider or facility.  Existing
law provides the criteria upon which the review is to be based.
   This bill would delete these provisions.
   (4) Existing law requires the director to make recommendations to
the Licensing and Certification Division in the State Department of
Health Services on licensure.
   This bill would specify criteria the director is required to use
in making the recommendation.
   (5) Existing law establishes requirements for the issuance by the
department and continued maintenance of provisional and regular
licenses for the operation of adult day health care centers, as well
as requiring a center to be approved by the department for
eligibility certification as an adult day health care center under
Medi-Cal.
   This bill would revise these licensing and certification
requirements.
   This bill would also permit the appeal of actions taken by the
department under these provisions.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:


  SECTION 1.  Section 1572 of the Health and Safety Code is amended
to read:
   1572.  (a) The functions and duties of the State Department of
Health Services provided for under this chapter shall be performed by
the California Department of Aging commencing on the date those
functions are transferred from the State Department of Health
Services to the California Department of Aging.  The authority,
functions, and responsibility for the administration of the adult day
health care program by the California Department of Aging and the
State Department of Health Services shall be defined in an
interagency agreement between the two departments that specifies how
the departments will work together.
   (b) The interagency agreement shall specify that the California
Department of Aging is designated by the state department as the
agency responsible for community long-term care programs.  At a
minimum, the interagency agreement shall clarify each department's
responsibilities on issues involving licensure and certification of
adult day health care providers, payment of adult day health care
claims, prior authorization of services, promulgation of regulations,
and development of adult day health care Medi-Cal rates.  In
addition, this agreement shall specify that the California Department
of Aging is responsible for making recommendations to the State
Department of Health Services regarding licensure as specified in
subdivision (h).  The interagency agreement shall specify that the
State Department of Health Services shall delegate to the California
Department of Aging the responsibility of performing the financial
and cost report audits and the resolution of audit appeals which are
necessary to ensure program integrity.   This agreement shall also
include provisions whereby the State Department of Health Services
and the California Department of Aging shall collaborate in the
development and implementation of health programs and services for
older persons and functionally impaired adults.
   (c) As used in this chapter, "director" shall refer to the
Director of the California Department of Aging or the Director of the
State Department of Health Services as specified in the interagency
agreement.
   (d) (1) A Long-Term Care Committee is hereby established in the
California Department of Aging.  The committee shall include, but not
be limited to, a member of the California Commission on Aging, who
shall be a member of the Long-Term Care Committee of the commission,
a representative of the California Association for Adult Day
Services, a representative of the California Association of Area
Agencies on Aging, a representative of the California Conference of
Local Health Officers, a member of a local adult day health care
planning council, nonprofit representatives and professionals with
expertise in Alzheimer's disease or a disease of a related disorder,
a member of the California Coalition of Independent Living Centers,
and representatives from other appropriate state departments,
including the State Department of Health Services, the State
Department of Social Services, the State Department of Mental Health,
the State Department of Developmental Services and the State
Department of Rehabilitation, as deemed appropriate by the Director
of the California Department of Aging.  At least one member shall be
a person over 60 years of age.
   (2) The committee shall function as an advisory body to the
California Department of Aging and advise the Director of the
California Department of Aging regarding development of
community-based long-term care programs.  This function shall also
include advice to the Director of the California Department of Aging
for recommendations to the State Department of Health Services on
licensure, Medi-Cal reimbursement, and utilization control issues.
   (3) The committee shall be responsible for the reviewing of new
programs under the jurisdiction of the department.
   (4) The committee shall assist the Director of the California
Department of Aging in the development of procedures and guidelines
for new contracts or grants, as well as review and make
recommendations on applicants.  The committee shall take into
consideration the desirability of coordinating and utilizing existing
resources, avoidance of duplication of services and inefficient
operations, and locational preferences with respect to accessibility
and availability to the economically disadvantaged older person.
   (e) The California Department of Aging shall prepare guidelines
for adoption by the local planning councils setting forth principles
for evaluation of community need for adult day health care, which
shall take into consideration the desirability of coordinating and
utilizing existing resources, avoidance of duplication of services
and inefficient operations, and locational preferences with respect
to accessibility and availability to the economically disadvantaged
older person.
   (f) The California Department of Aging shall review county plans
submitted pursuant to Section 1572.9.  These county plans shall be
approved if consistent with the guidelines adopted by the director
pursuant to subdivision (e).
   (g) The Director of the California Department of Aging shall make
recommendations regarding licensure to the Licensing and
Certification Division in the State Department of Health Services.
The recommendation shall be based on all of the following criteria:
   (1) An evaluation of the ability of the applicant to provide adult
day health care in accordance with the requirements of this chapter
and regulations adopted hereunder.
   (2) Compliance with the local approved plan.
   (3) Other criteria that the director deems necessary to protect
public health and safety.
   (h) A public hearing on each individual proposal for an adult day
health care center may be held by the department in conjunction with
the local adult day health care council in the county to be served.
A hearing shall be held if requested by a local adult day health care
council.  In order to provide the greatest public input, the hearing
should preferably be held in the service area to be served.
  SEC. 2.  Section 1575.3 of the Health and Safety Code is amended to
read:
   1575.3.  (a) If an adult day health care center or an applicant
for a license has not been previously licensed, the department may
only issue a provisional license to the center as provided in this
section.
   (b) A provisional license to operate an adult day health care
center shall expire one year from the date of issuance, or at an
earlier time as determined by the department at the time of issuance.

   (c) Within 30 days prior to the expiration of a provisional
license, the department shall give the adult day health care center a
full and complete inspection, and, if the adult day health care
center meets all applicable requirements for licensure, a regular
license shall be issued.  If the adult day health care center does
not meet the requirements for licensure but has made substantial
progress towards meeting the requirements, as determined by the
department, the initial provisional license shall be renewed for six
months.
   (d) If the department determines that there has not been
substantial progress towards meeting licensure requirements at the
time of the first full inspection provided by this section, or, if
the department determines upon its inspection made within 30 days
prior to the termination of a renewed provisional license that there
is lack of full compliance with the requirements, no further license
shall be issued.
   (e) If an applicant for a provisional license to operate an adult
day health care center has been denied  a license, the applicant may
contest the denial by  requesting an adjudicative hearing.  The
proceedings to review the denial shall be conducted pursuant to
Section 100171.
   (f) The department shall not apply less stringent criteria when
issuing a provisional license pursuant to this section than it
applies when  issuing a regular license.
  SEC. 3.  Section 1575.4 of the Health and Safety Code is amended to
read:
   1575.4.  (a) The department may issue a provisional license to an
adult day health care center if all of the following conditions are
met:
   (1) The adult day health care center and the applicant for
licensure substantially meet the standards specified by this chapter
and regulations adopted pursuant to this chapter.
   (2) No violation of this chapter or regulations adopted under this
chapter exists in the adult day health care center  that jeopardizes
the health or safety of patients.
   (3) The applicant has adopted a plan for correction of any
existing violations  that is satisfactory to the department.
   (b) A provisional license issued under this section shall expire
not later than one year after the date of issuance, or at an earlier
time as determined by the department at the time of issuance, and may
not be renewed.
   (c) At the expiration of the provisional license period, the
department shall assess the adult day health care center's full
compliance with licensure requirements.  If the adult day health care
center meets all applicable requirements for licensure, the
department shall issue a regular license.
   (d) The department shall not apply less stringent criteria when
issuing a provisional license pursuant to this section than it
applies when  issuing a regular license.
  SEC. 4.  Section 1575.45 is added to the Health and Safety Code,
immediately following Section 1575.4, to read:
   1575.45.  (a) If the department determines that the adult day
health care center operating under a provisional license has serious
deficiencies that pose a risk to the health and safety of the
participants, the department may immediately take any of the
following actions, including, but not limited to:
   (1) Require a plan of correction.
   (2) Limit participant enrollment.
   (3) Prohibit new participant enrollment.
   (b) When appropriate, the California Department of Aging and the
department shall coordinate an action or actions to ensure
consistency and uniformity.
   (c) The licensee shall have the right to dispute an action or
actions taken pursuant to paragraphs (2) and (3) of subdivision (a).
The department shall accept, consider, and resolve disputes filed
pursuant to this  subdivision by a licensee in a timely manner.
   (d) The director shall ensure that public records accurately
reflect the current status of any action or actions taken pursuant to
this section, including any resolution of disputes.
  SEC. 5.  Section 1576 of the Health and Safety Code is amended to
read:
   1576.  All applications for a new license shall be submitted to
the planning council for the county in which the adult day health
care center will be located, if an approved planning council exists,
which shall review the application as provided in Section 1573.  The
director shall approve the application if it is determined to be
consistent with the existing county plan, no substantial basis for
denial of the license exists under Section 1575.7, and the applicant
has met all the requirements for licensure set forth in this chapter
and regulations adopted hereunder.  Otherwise the director shall deny
issuance of the license.
  SEC. 6.  Section 1580.5 of the Health and Safety Code is amended to
read:
   1580.5.  (a) Every adult day health care center shall be
periodically inspected and evaluated for quality of care by a
representative or representatives designated by the director.
Inspections shall be conducted prior to the expiration of
certification or at least every two years and as often as necessary
to ensure the quality of care being provided, whether initiated by
the state department or pursuant to Section 1580.9.  As resources
permit, an inspection may be conducted prior to, as well as within
the first 90 days of, adult day health care center operation.
   (b) After each inspection, the state department shall notify the
adult day health care center in writing of any deficiencies in its
compliance with this chapter and the rules and regulations adopted
pursuant to this chapter, and shall set a reasonable length of time
for compliance by the facility.  Upon a finding of noncompliance, the
state department may also assess a civil penalty not to exceed fifty
dollars ($50) per day for each violation continuing beyond the date
fixed in the notice for correction.  If the violation is not
corrected within that time, the civil penalty shall accrue from the
date of receipt of the notice by the licensee.  If the violation
continues beyond the date fixed for correction, the state department
may also initiate action against the licensee in accordance with
Article 7 (commencing with Section 1595).
   (c) When a civil penalty is to be assessed pursuant to this
section, the notice shall specify the amount thereof and shall be
served upon the licensee in a manner prescribed by subdivision (c) of
Section 11505 of the Government Code.  Any judicial action required
to collect a civil penalty assessed pursuant to this section shall be
brought by the Attorney General acting on behalf of the state
department in the superior court of the county in which the adult day
health care center is located.
  SEC. 7.  Section 1590.3 is added to the Health and Safety Code, to
read:
   1590.3.  (a) The denial, suspension, or revocation of a center's
license shall be considered immediate grounds for the denial,
suspension, or termination of the center's certification.
   (b) Proceedings to deny an application for licensure or
certification, suspend a license or certification, or revoke a
license or terminate certification shall be consolidated whenever
possible.
  SEC. 8.  Section 1590.5 of the Health and Safety Code is amended to
read:
   1590.5.  Proceedings for the suspension, revocation, or denial of
a license under this article shall be conducted in accordance with
Section 100171.  Except as provided in Section 1591, Section 100171
shall prevail in the event of a conflict between this chapter and
Section 100171.  The director shall ensure that public records
accurately reflect the current status of any potential  adverse
action or actions, including the resolution of disputes.
  SEC. 9.  Section 14574 of the Welfare and Institutions Code is
amended to read:
   14574.  (a) The director shall terminate the Medi-Cal
certification of any adult day health care provider at any time if he
or she finds the provider is not in compliance with standards
prescribed by this chapter or chapter 7 (commencing with Section
14000) or regulations adopted pursuant to  these chapters.  The
director shall give reasonable notice of his or her intention to
terminate the certification to the provider and participants in the
plan.  The notice shall state the effective date of, and the reason
for, the termination.
   (b) The denial, suspension, or termination of certification shall
be considered immediate grounds for denial, suspension, or revocation
of the license.
   (c) Proceedings to deny an application for certification or
licensure, terminate or suspend certification, or revoke or suspend
licensure shall be consolidated whenever possible.
   (d) The California Department of Aging and the State Department of
Health Services shall coordinate an action or actions to the extent
appropriate to ensure consistency and uniformity.
   (e) The provider shall have the right to appeal the department's
decision made pursuant to Section 14123.
  SEC. 10.  Section 14574.1 is added to the Welfare and Institutions
Code, to read:
   14574.1.  (a) Every adult day health care center shall be
periodically inspected and evaluated for quality of care by a
representative or representatives designated by the director.
Inspections shall be conducted prior to the expiration of
certification, but at least every two years, and as often as
necessary to ensure the quality of care being provided.  As resources
permit, an inspection may be conducted prior to, as well as within,
the first 90 days of operation.
   (b) If the department determines that the adult day health care
center has serious deficiencies that pose a risk to the health and
safety of the participants, the department may immediately take any
of the following actions, including, but not limited to:
   (1) Require a plan of correction.
   (2) Limit participant enrollment.
   (3) Prohibit new participant enrollment.
   (c) The provider shall have the right to dispute an action taken
under paragraphs (2) and (3) of subdivision (b).  The department
shall accept, consider, and resolve disputes filed pursuant to this
subdivision in a timely manner.
   (d) The director shall ensure that public records accurately
reflect the current status of any potential actions including the
resolution of disputes.
